title: The contribution of trigemino-cervical reflexes in distinguishing progressive supranuclear palsy from multiple system atrophy.
abstract: OBJECTIVE
  Trigemino-cervical reflexes (TCRs) are electromyographic responses induced by electrical stimulation of the trigeminal nerve and recorded in the neck muscles. Trigemino-cervical reflexes are detectable in Parkinson's disease, whereas they are absent in progressive supranuclear palsy (PSP), an atypical parkinsonism associated with brainstem degeneration. To date, no study has investigated TCRs in multiple system atrophy (MSA), another atypical parkinsonism associated with brainstem involvement, which resembles PSP.
  
  
  METHODS
  To understand whether TCRs are helpful in differentiating PSP from MSA, we compared the TCRs recorded in 10 PSP patients with those obtained from 10 patients diagnosed as having probable MSA, parkinsonian type (MSA-P).
  
  
  RESULTS
  Trigemino-cervical reflexes were not recorded in any of the PSP patients, while they were clearly detectable in all the MSA-P patients.
  
  
  CONCLUSIONS
  Trigemino-cervical reflex recording is a rapid neurophysiological method, which could assist in the differential diagnosis between PSP and MSA-P.
  
  
  CONCLUSIONS
  This study further improves our understanding of the different neuronal functioning of extrapyramidal disorders. TCRs monitoring may be useful to support the diagnosis of atypical parkinsonisms especially when clinical evidence is uncertain.
authors.affiliation: Department of Medical and Surgical Science and Biotechnology, Sapienza University of Rome ICOT - Polo Pontino, Latina, Italy.
authors.forename: Mariano
authors.initials: M
authors.lastname: Serrao
authors.forename: Roberto
authors.initials: R
authors.lastname: Di Fabio
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Bartolo
authors.forename: Armando
authors.initials: A
authors.lastname: Perrotta
authors.forename: Cristina
authors.initials: C
authors.lastname: Tassorelli
authors.forename: Gianluca
authors.initials: G
authors.lastname: Coppola
authors.forename: Chiara
authors.initials: C
authors.lastname: Davassi
authors.forename: Luca
authors.initials: L
authors.lastname: Padua
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sandrini
authors.forename: Francesco
authors.initials: F
authors.lastname: Pierelli
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D019578:Multiple System Atrophy / Q000175:diagnosis* / Q000503:physiopathology; D009334:Neck Muscles / Q000294:innervation; D012018:Reflex / Q000502:physiology*; D012021:Reflex, Abnormal / Q000502:physiology; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis* / Q000503:physiopathology; D014276:Trigeminal Nerve / Q000502:physiology